Inflammation and the Host Response to Injury, a Large-Scale Collaborative Project: Patient-Oriented Research Core Standard Operating Procedures for Clinical Care IX. Definitions for Complications of Clinical Care of Critically Injured Patients
Inflammation and the Host Response to Injury, a Large-Scale Collaborative Project: Patient-Oriented Research Core Standard Operating Procedures for Clinical Care IX. Definitions for Complications of Clinical Care of Critically Injured Patients
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DOI：
10.1097/ta.0b013e3181ad66a7
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发表时间：
2009-08-01
影响因子：
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通讯作者：
West, Michael A.
中科院分区：
文献类型：
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作者：
Evans, Heather L.;Cuschieri, Joseph;West, Michael A.
由美国国立卫生研究院国家普通医学科学研究所资助的炎症和宿主对损伤的反应大规模合作研究计划是第一个试图解决重大创伤或烧伤后炎症威胁生命问题的大规模跨学科计划。该项目的主要目标之一是开发一个大型临床数据库，其中包含基线患者特征和与损伤后宿主炎症反应相关的明确结局。为了最大限度地减少参与研究中心之间实践差异的影响，在项目开始时，根据与专家共识一致的最佳可用证据制定了临床指南。1由此产生的实践指南标准已提供给临床社区，以确保研究计划的透明度，强调这些最佳实践的适用性，并促进持续发展的一致性，高质量的护理。认识到患者人群的复杂性和异质性，研究人员还创建了创伤后并发症的标准化诊断标准库。用于定义这些并发症的方法包括几个关键组成部分。一个由参与以患者为中心的研究核心的外科医生组成的专家小组被召集起来，以确定和列举创伤性损伤后出现的并发症，并将其纳入研究数据库。定义基于现有最佳证据，并进行了澄清，以试图明确描述并发症，从而可以获取与该并发症相关的可靠数据。创伤研究护士也对共识过程进行了输入，以修改定义，从而根据病历中的可用信息促进并发症的实际测量。虽然主要目的是在参与的创伤中心之间保持一致的治疗和结局报告和质量评估，但在单一来源中汇编这些感染性和非感染性并发症定义可作为临床医生的有用参考，以及未来研究的框架。
The Inflammation and Host Response to Injury Large-Scale Collaborative Research program, funded by the National Institute of General Medical Sciences of the National Institutes of Health, is the first large-scale interdisciplinary program to attempt to solve the life-threatening problem of inflammation after major trauma or burn injury. One of the main goals of the project was to develop a large clinical database with baseline patient characteristics and well-defined outcomes that pertain to the host inflammatory response after injury. To minimize the impact of practice variation between participating sites, clinical guidelines were developed at the outset of the project, based on the best available evidence in concert with expert consensus. 1 The resultant standards of practice guidelines have been provided to the clinical community to ensure transparency of the research initiative, highlight the applicability of these best practices, and to promote the ongoing development of consistent, high-quality care.Recognizing the complexity and heterogeneity of the patient population, the investigators have additionally created a library of standardized diagnostic criteria for complications after traumatic injury. The method used to define these complications incorporated several key components. An expert panel of surgeons who were participating investigators in the Patient-Oriented Research Core was assembled to identify and enumerate the complications that arise after traumatic injury to be included in the study database. Definitions were based on the best available evidence and were clarified to attempt to unambiguously describe complications in such a manner that reliable data could be captured relative to that complication. Input into the consensus process was also obtained from trauma research nurses to modify the definitions to facilitate practical measurement of complications based on information available in the medical record. Although the primary intent was to maintain consistent reporting and quality assessment of treatment and outcomes among participating trauma centers, the compilation of these infectious and noninfectious complication definitions in a single source may serve as a useful reference for the clinician, as well as a framework for future research.